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Reproducibility of 6- and 4-category faces pain scale to the assessment of temporomandibular joint pain and muscle in school-age children

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Abstract

Objective

The aim of this study was to compare the levels of reproducibility between two Faces Pain Scales (FPS) of 6 and 4 categories to the assessment of pain intensity on children with and without Temporomandibular joint and muscle pain.

Material and methods

A total of 29 children were recruited: 13 symptomatic (9.79 ± 1.36 years old) and 16 asymptomatic (8.69 ± 0.87 years old). One previously-trained examiner applied manual palpation to evaluate orofacial structures, and FPS to assess pain intensity. All children were initial evaluated using 6-category FPS and after 3 days using 4-category FPS. The children were assessed after a seven day time interval from initial and second sessions. Weighted Kappa coefficient was used to verify reproducibility levels.

Results

Similar levels of reproducibility (moderate and fair kappa values) have been verified with the application of the 6-category FPS on symptomatic and asymptomatic children. Similar results were verified using 4-category FPS on symptomatic and asymptomatic children (poor and fair kappa values).

Conclusion

Higher levels of reproducibility were verified with the application of the 6-category FPS in both groups and considering symptomatic and asymptomatic as single group. In this way, the 6-category FPS should be preferred over the 4-category FPS to assess pain intensity on children’s orofacial structures.

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References

  • American Dental Association. Report of the president’s conference on the examination, diagnosis and management of temporomandibular disorders. JADA. 1983;106(1):75–7.

    Google Scholar 

  • Atwood MJ, Dixon DC, Talcott GW, et al. Comparison of two scales in the assessment of muscle and joint palpation tenderness in chronic temporomandibular disorders. J Orofac Pain. 1993;7(4):403–7.

    PubMed  Google Scholar 

  • Bieri D, Reeve RA, Champion GD, et al. The FPS for the self-assessment of the severity of pain experienced by children: development, initial validation, and preliminary investigation for ratio scale properties. Pain. 1990;41:139–50.

    Article  PubMed  Google Scholar 

  • Bonjardim LR, Gavião MBD, Carmagnani FG, et al. Signs and symptoms of temporomandibular joint dysfunction in children with primary dentition. J Clin Pediatr Dent. 2003;28(1):53–8.

    PubMed  Google Scholar 

  • Castelo PM, Gavião MB, Pereira LJ, et al. Relationship between oral parafunctional/nutritive sucking habits and temporomandibular joint dysfunction in primary dentition. Int J Paediatr Dent. 2005;15(1):29–36.

    Article  PubMed  Google Scholar 

  • Chambers CT, Giesbrecht K, Craig KD, et al. A comparison of faces scales for the measurement of pediatric pain: children’s and parents’ ratings. Pain. 1999;1:25–35.

    Article  Google Scholar 

  • Chaves TC, Nagamine HM, de Sousa LM, et al. Intra- and interrater agreement of pressure pain threshold for masticatory structures in children reporting orofacial pain related to temporomandibular disorders and symptom-free children. J Orofac Pain. 2007;21(2):133–42.

    PubMed  Google Scholar 

  • Conti PC, de Azevedo LR, de Souza NV, et al. Pain measurement in TMD patients: evaluation of precision and sensitivity of different scales. J Oral Rehabil. 2001;28(6):534–9.

    Article  PubMed  Google Scholar 

  • Decruynaere C, Thonnard JL, Plaghki L. How many response levels do children distinguish on faces scales for pain assessment? Eur J Pain. 2009;13(6):641–8.

    Article  PubMed  Google Scholar 

  • Dworkin SF, LeResche L. Research diagnostic criteria for temporomandibular disorders: review, criteria, examinations and specifications, critique. J Craniomandib Disord. 1992;6:301–55.

    PubMed  Google Scholar 

  • Fonseca DM, Bonfate G, Valle AL, et al. Diagnóstico pela anamnese da disfunção craniomandibular. Rev Gaucha Odontol. 1994;42:23–8.

    Google Scholar 

  • Hicks CL, Von Baeyer CL, Spafford PA, et al. The FPS—revised: toward a common metric in pediatric pain measurement. Pain. 2001;93:173–83.

    Article  PubMed  Google Scholar 

  • Kay DJ, Rosenfeld RM. Quality of life for children with persistent sinonasal symptoms. Otolaryngol Head Neck Surg. 2003;128:17–26.

    Article  PubMed  Google Scholar 

  • Landis RJ, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–74.

    Article  PubMed  Google Scholar 

  • LeResche L, Burgess J, Dworkin SF. Reliability of visual analog and verbal descriptor scales for “objective” measurement of temporomandibular disorder pain. J Dent Res. 1988;67(1):33–6.

    Article  Google Scholar 

  • List T, Helkimo M, Falk G. Reliability and validity of a pressure threshold meter in recording tenderness in the masseter muscle and the anterior temporalis muscle. Cranio. 1989;7:223–9.

    PubMed  Google Scholar 

  • Mohl ND. Standards for testing new diagnostic strategies for temporomandibular disorders. In: Fricton JR, Dubner RB, editors. Orofacial pain and temporomandibular disorders. Advances in pain research and therapy. New York: Raven Press; 1994.

    Google Scholar 

  • Reid KI, Gracely RH, Dubner RA. The influence of time, facial side, and location on pain-pressure thresholds in chronic myogenous temporomandibular disorder. J Orofac Pain. 1994;8:258–65.

    PubMed  Google Scholar 

  • Schiffman EL, Truelove EL, Ohrbach R, et al. The research diagnostic criteria for temporomandibular disorders. I: overview and methodology for assessment of validity. J Orofac Pain. 2010;24(1):7–24.

    PubMed Central  PubMed  Google Scholar 

  • Sim J, Wright CC. The kappa statistic in reliability studies: use, interpretation, and sample size requirements. Phys Ther. 2005;85(3):257–68.

    PubMed  Google Scholar 

  • Stanford EA, Chambers CT, Craig KD. The role of developmental factors in predicting young children’s use of a self-report scale for pain. Pain. 2006;120(1–2):16–23.

    Article  PubMed  Google Scholar 

  • Stinson JN, Kavanagh T, Yamada J, et al. Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents. Pain. 2006;125(1–2):143–57.

    Article  PubMed  Google Scholar 

  • Vanderas AP, Papagiannoulis L. Multifactorial analysis of the etiology of temporomandibular dysfunction in children. Int J Paediatr Dent. 2002;12:336–46.

    Article  PubMed  Google Scholar 

  • Vierola A, Suominen AL, Ikavalko T, et al. Clinical signs of temporomandibular disorders and various pain conditions among children 6 to 8 years of age: the PANIC study. J Orofac Pain. 2012;26(1):17–25.

    PubMed  Google Scholar 

  • Visscher CM, Lobbezoo F, Naeije M. Comparison of algometry and palpation in the recognition of temporomandibular disorder pain complaints. J Orofac Pain. 2004;18:214–9.

    PubMed  Google Scholar 

  • von Baeyer CL, Forsyth SJ, Stanford EA, et al. Response biases in preschool children’s ratings of pain in hypothetical situations. Eur J Pain. 2009;13(2):209–13.

    Article  Google Scholar 

  • Wahlund K, List T, Dworkin SF. Temporomandibular disorders in children and adolescents: reliability of a questionnaire, clinical examination, and diagnosis. J Orofac Pain. 1998;12:42–51.

    PubMed  Google Scholar 

  • Wong DL, Baker CM. Pain in children: comparison of assessment scales. Pediatr Nurs. 1988;14:9–17.

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors acknowledge FAPESP (São Paulo State Research Foundation) for financial support to this study (Grants #2003/07771-0) and CAPES (Master degree scholarship).

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Correspondence to T. C. Chaves.

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Chaves, T.C., Turci, A.M., Nagamine, H.M. et al. Reproducibility of 6- and 4-category faces pain scale to the assessment of temporomandibular joint pain and muscle in school-age children. Eur Arch Paediatr Dent 15, 135–142 (2014). https://doi.org/10.1007/s40368-013-0076-x

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  • DOI: https://doi.org/10.1007/s40368-013-0076-x

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